National Provider Identifier
Dominique S Fertal, CRNA
Dominique S Fertal, CRNA is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist in Canandaigua, NY and a listed phone number of (585) 919-2668.
Profile Overview
- NPI
- 1891220810
- Provider Type
- Individual
- Primary Specialty
- Certified Registered Nurse Anesthetist
- Enumeration Date
- April 27, 2017
- Last Updated
- January 13, 2020
Practice Location
- 350 Parrish St
- Canandaigua, NY 14424-1731
Phone: (585) 919-2668
Mailing Address
- 601 Elmwood Ave Box 604
- Rochester, NY 14642-0001
Specialties
- Certified Registered Nurse Anesthetist (367500000X)
- Certified Registered Nurse Anesthetist (367500000X)
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1891220810
- Entity Type
- Individual
- Last Name
- Fertal
- First Name
- Dominique
- Middle Name
- S
- Credential
- CRNA
- Provider Other Last Name
- Stryker
- Provider Other First Name
- Dominique
- Provider Other Middle Name
- S
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 601 Elmwood Ave Box 604
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 275-1385
- Practice Street Address
- 350 Parrish St
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-1731
- Practice Country
- US
- Practice Phone
- (585) 919-2668
- Practice Fax
- (585) 396-6455
- Enumeration Date
- April 27, 2017
- Last Updated
- January 13, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 13, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Certified Registered Nurse Anesthetist (367500000X), Certified Registered Nurse Anesthetist (367500000X), Registered Nurse (163W00000X)